Alumni Mentoring Program Registration Form


Name:
Business Address:
Business Telephone: Other Telephone:
Fax: E-Mail:
Law School, if not W&L: Law Graduation Year:
Undergraduate School: Current Employer:
Please list other relevant past employers:
If you served as a judicial law clerk, please indicate the judge and court:

Legal Practice Settings: (Please indicate each setting you can discuss with students, whether or not it is your current employment setting.)
federal government public interest business, non-legal
state government military academia
local / municipal government private practice other:
judiciary in-house / corporate counsel

Primary Subject Matter Area(s) of Law Practice:
administrative / regulatory education labor and employment
admiralty / aviation / transportation elder law litigation
antitrust environment, energy, resources public contracts
bankruptcy entertainment, sports public utility
communications estate, trust, probate real property
construction family law science / technology
corporate, general / advice general practice state / local government
corporate, transactional health care taxation, ERISA
corporate finance immigration tort trial, insurance
criminal justice individual rights / responsibilities other:
disability intellectual property
dispute resolution international

Size of each Office in which you practice or have practiced, in number of attorneys:(Please indicate each office size you are able to discuss with students.)
< 3 3 - 10 10 - 25 26 - 50 51 - 100 101 - 250 251- 500 > 500

If possible, we may be able to match you with a student who has indicated a special interest in working with a mentor who has identified him/herself as a member of a special group (e.g. second career students, married students, people of color, gay/lesbian, women, etc.). If you are interested in such a match, please tell us:

Please list any community or bar activities:

Are there any geographic areas you can discuss with a mentee other than the area in which you now practice?
If so, please indicate which cities/states/regions::

How may a mentee contact you? (check as many as apply)
Telephone E-mail U.S. mail